The Geriatric Depression Scale-15 (GDS-15) is a validated 15-item yes/no questionnaire developed by Sheikh and Yesavage (1986) specifically for depression screening in older adults. It avoids somatic items that overlap with normal aging and physical illness, making it the preferred depression screening tool in geriatric and medical settings.

How is the GDS-15 scored?

Score 1 point for each depressive-keyed response: 'No' for items 1, 5, 7, 11, 13; 'Yes' for all other items. Total range 0-15. Interpretation: 0-4 = normal; 5-8 = mild depression; 9-11 = moderate; 12-15 = severe. Clinical threshold ≥5 or ≥6 is commonly used for positive screening.

What is the clinical threshold for positive GDS-15?

Most studies and guidelines use ≥5 or ≥6 as the positive screening threshold. At ≥5: sensitivity approximately 92%, specificity 81%. At ≥6: sensitivity approximately 86%, specificity 78% for major depression. The specific threshold may vary by clinical setting and population.

Why is GDS-15 preferred over PHQ-9 in elderly patients?

GDS-15 avoids somatic items (sleep, appetite, energy, fatigue, concentration) that PHQ-9 includes. These somatic items are commonly elevated in elderly patients due to normal aging, chronic illness, and medications — not depression — causing PHQ-9 to over-screen. GDS-15 focuses on psychological symptoms providing better specificity in older adults.

Can GDS-15 be used in patients with dementia?

GDS-15 is valid for patients with mild-to-moderate cognitive impairment (MMSE ≥12-15) who can still provide reliable yes/no responses. For moderate-to-severe dementia (MMSE <12), the Cornell Scale for Depression in Dementia (CSDD) is recommended — it does not require patient self-report, using caregiver and clinician observation instead.

What are the symptoms of depression in older adults?

Late-life depression often presents differently from younger adults: more somatic complaints, more cognitive symptoms (concentration, memory), prominent anxiety, less reported sadness or tearfulness (masked depression), social withdrawal, weight loss, and new or worsening pain complaints. GDS-15 captures these age-specific presentations effectively.

What treatments are recommended for late-life depression?

First-line treatment: SSRIs (sertraline, escitalopram — preferred; avoid paroxetine due to anticholinergic effects in elderly). SNRIs, bupropion, and mirtazapine are alternatives. Psychotherapy (CBT, problem-solving therapy) is effective alone or combined with medication. Exercise has strong evidence for mild-moderate late-life depression.

Why is depression in elderly people important to treat?

Untreated late-life depression is associated with: 2-3× increased risk of dementia, increased cardiovascular mortality, accelerated functional decline, higher suicide risk (elderly men have the highest suicide completion rates), increased healthcare utilization, and reduced quality of life. Treatment significantly improves all these outcomes.

What is GDS-30 and how does it differ from GDS-15?

GDS-30 is the original 30-item version developed by Yesavage et al. (1982). GDS-15 is a validated abbreviated version that takes half the time to complete. Both have comparable sensitivity and specificity. GDS-5 (5-item) and GDS-4 (4-item) ultra-brief versions also exist for rapid screening in time-constrained settings.

Is suicide risk higher in elderly patients?

Yes. Despite lower attempt rates, elderly adults (particularly white men over 85) have the highest suicide death rates of any demographic group. Methods used tend to be more lethal (firearms). Risk factors include depression, chronic pain, disability, social isolation, and bereavement. Always assess suicidal ideation in GDS-15 positive patients.

What does a GDS-15 score of 5-8 mean?

A score of 5-8 indicates mild depression signal, warranting clinical follow-up. This should include: direct clinical interview assessing DSM-5 major depressive episode criteria, assessment of duration and functional impact, suicidal ideation assessment, identification of contributing factors (medical, social, bereavement), and determination of treatment need.

How is GDS-15 administered to patients who cannot write?

GDS-15 is validated for verbal administration — the clinician reads each question aloud and records the patient's yes/no answer. This is particularly useful for visually impaired elderly patients or those with physical limitations. Verbal administration takes approximately 5-7 minutes and does not compromise validity.

Online Medical Tools — GDS-15

Printed on 9/3/2026

For informational purposes only. This is not medical advice.

Mental Health

GDS-15

GDS-15 is a brief geriatric-focused depression screening tool designed to reduce somatic symptom bias in older populations and support quick mood triage in outpatient, inpatient, and community settings.

Formula: GDS-15 total = sum of depressive-keyed responses (0-15).

Are you basically satisfied with your life?

Have you dropped many activities and interests?

Do you feel your life is empty?

Do you often get bored?

Are you in good spirits most of the time?

Are you afraid something bad is going to happen to you?

Do you feel happy most of the time?

Do you often feel helpless?

Do you prefer to stay home rather than going out?

Do you feel you have more memory problems than most?

Do you think it is wonderful to be alive now?

Do you feel pretty worthless the way you are now?

Do you feel full of energy?

Do you feel your situation is hopeless?

Do you think most people are better off than you are?

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How It Works

Elderly Patient Answers 15 Yes/No Questions

The older adult patient answers 15 yes/no questions about their mood over the past week. The scale was specifically designed for verbal or written administration in elderly patients and avoids somatic symptom items that overlap with normal aging and physical illness.

Score Depressive-Keyed Responses (0–15)

Most items score 'Yes' as the depressive response (1 point), but 5 items are reverse-scored (items 1, 5, 7, 11, 13 where 'No' = 1 point). Sum all depressive-keyed responses for a total of 0-15.

Interpret and Determine Clinical Threshold

Score interpretation: 0-4 = normal; 5-8 = mild depression; 9-11 = moderate depression; 12-15 = severe depression. The clinical screening threshold of ≥6 (some protocols ≥5) has sensitivity ~86%, specificity ~78% for major depression. Positive screens require clinical diagnostic evaluation.

Who Uses the GDS-15

Geriatric Medicine Depression Screening

Geriatricians & Internists

GDS-15 is the standard depression screening tool in geriatric medicine, designed specifically for older adults with language optimized for readability and items validated in populations with multiple medical comorbidities.

Primary Care Elderly Depression Assessment

Primary Care Physicians

USPSTF recommends depression screening for all adults including the elderly. GDS-15 is the preferred validated tool for patients aged 65 and older in primary care, avoiding somatic items that PHQ-9 uses which may be confounded by age-related symptoms and chronic illness.

Nursing Home and Long-Term Care Screening

Nursing Home Staff & Social Workers

Depression affects 15-25% of nursing home residents and is chronically under-recognized in long-term care settings. GDS-15 can be administered verbally to residents and provides a standardized, validated screen for depression requiring staff follow-up.

Post-Hospitalization Depression Assessment

Discharge Planners & Home Health Nurses

Depression following hospitalization dramatically increases readmission risk and mortality in older adults. GDS-15 administered at discharge or during early post-discharge follow-up identifies patients needing mental health referral alongside medical management.

Dementia Care Depression Monitoring

Alzheimer's Disease & Dementia Care Teams

Depression co-occurs with early dementia in up to 40% of patients and worsens functional outcomes. GDS-15 is valid in cognitively intact and mildly impaired patients (MMSE ≥12-15), enabling regular depression monitoring in dementia care plans.

Pro Tips

GDS-15 Avoids Somatic Items — Critical for Elderly Patients

Unlike PHQ-9, GDS-15 deliberately excludes somatic items (sleep problems, appetite changes, fatigue, energy) that overlap with normal aging and chronic physical illness in older adults. This specificity is critical — PHQ-9 frequently over-screens in elderly populations due to somatic symptom confounding.

Not Valid in Moderate-to-Severe Dementia (MMSE < 12-15)

GDS-15 requires reliable self-report and is not valid when MMSE falls below approximately 12-15 (moderate-to-severe dementia). For patients with advanced dementia, use the Cornell Scale for Depression in Dementia (CSDD) — an observational clinician-rated tool not requiring self-report.

Late-Life Depression Is Under-Treated With Serious Consequences

Depression in older adults is associated with increased risk of cardiovascular events, accelerated cognitive decline, disability, and mortality. Yet approximately 50% of late-life depression goes untreated in primary care. Routine GDS-15 screening is essential to identify this undertreated condition.

Suicide Risk in Elderly Is Highest of Any Age Group

Despite lower attempt rates, elderly adults — particularly white men over 85 — have the highest suicide completion rates of any age group. Firearm access is a major risk factor. Always assess suicidal ideation in patients with positive GDS-15 scores, particularly depressed elderly men.

Avoid Paroxetine in Elderly Depression

When treating late-life depression, SSRIs are first-line (sertraline and escitalopram preferred). Paroxetine should be avoided in the elderly due to strong anticholinergic effects causing cognitive impairment, urinary retention, and falls. Tricyclic antidepressants are also contraindicated in elderly patients.

Exercise Has Strong Evidence for Late-Life Depression

Aerobic exercise has robust evidence for improving depression symptoms in older adults, with effect sizes comparable to antidepressants in mild-moderate depression. Exercise is recommended alongside or instead of pharmacotherapy for older adults with mild depression or those unable to tolerate medication.

Distinguish Depression From Dementia

Depression and dementia frequently co-occur and can clinically resemble each other — 'pseudodementia' (depression presenting with cognitive deficits) can mimic dementia. GDS-15 positive + cognitive impairment warrants trial of antidepressant before assuming dementia diagnosis, as depression-related cognitive impairment is reversible with treatment.

Always Reassess After Treatment Initiation

GDS-15 should be repeated at 4-6 weeks after treatment initiation to assess response. A ≥50% reduction in GDS-15 score indicates treatment response. Persistent elevation despite adequate antidepressant treatment warrants referral to geriatric psychiatry for more complex assessment and management.

Common Questions About Your Results

Evidence-Based Methodology

GDS-30 original by Yesavage et al. (J Psychiatr Res 1982-83). GDS-15 shortened version by Sheikh & Yesavage (Clin Gerontol 1986). GDS-15 sensitivity 86%, specificity 78% for depression in community-dwelling elderly. Validated in cognitively intact nursing home residents and primary care. Not valid in MMSE <12. USPSTF Grade B recommendation for depression screening in all adults including elderly. AGS (American Geriatrics Society) and NICE recommend GDS-15 for routine geriatric depression screening.

Clinical Content Trust

Last reviewed:: April 21, 2026
Guideline version:: General evidence framework v2026.04
Source set version:: Primary-source set v1

How to Interpret Your Result

Higher GDS-15 scores indicate greater late-life depressive symptom burden and support formal mood evaluation.

When to Use This Tool

Use for depression screening in older adults across primary care, geriatric, and long-term care contexts.

Limitations

GDS-15 depends on reliable self-report and may be less accurate in severe cognitive impairment or communication limitations without supportive assessment.

For related assessments, see PHQ-9, MDI Depression Scale and MoCA Score.

Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.

Changelog

April 21, 2026 · trust-baseline
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